Battling Childhood Obesity By Focusing on Health and Fitness

Fostering healthy eating and fitness is often a wrestling match of Olympic proportions. In one corner, our kids highly motivated but under trained in the rules of health. In the other, the tag team of activity and food which can change as fast as a chameleon from working for the health of your child to a pure health enemy.

You never know what you’ll get in the ring – exercise or video games. Cookies or carrot sticks. You, the parent, are the referee, and get to play dirty. This is one match where referee interference is not only expected but crucial for our kids to have the winning move.

Bob vs. Carb: losing by default

Kelli is mom to a typical 8 year old son, who I’ll call Bobby. Kelli’s son is in a match against junk food and lack of exercise and appears to be losing. Standing 51” tall and weighing 85 pound, Bobby prefers carbohydrates and meat to fruits and veggies and is described as “hungry all the time.” According to a standard growth chart, he is at the 75%ile for height and above the 95%ile for weight.  This is overweight by today’s standards.

When Bobby was young, he was a very picky eater and really never developed a taste for many fruits and veggies. So, his parents gave him what he would eat to avoid struggles. As he got older, those patterns never changed.  For Bobby to turn this around, he needs to move more and eat differently and perhaps even less.

Bobby would benefit from the Ref Kelli calling him on shady plays and unwise moves. Perhaps the ref could take on more of a coaching role to help Bobby view this a bit more positively. So, “you can’t eat that right now” can become “if you want a snack, you can have some carrot sticks with ranch dressing or peanut butter, or a yogurt”. Ref Kelli will have to be tough because Bobby may pull out his secret whining weapon. While that can make the match proceed more smoothly, it is a set up for sure loss. For Bobby to win, he has to start playing by new rules. And, Ref Kelli has to recognize that the players of this match have to change. Junk food needs to be thrown out of the ring, and healthy food allowed to enter. Similarly, exercise needs to have a bigger role.

Kids love games. If Bobby views this as a game, he may just get on board quicker with stomping out his carb consumed opponent. Perhaps he’ll be convinced to walk around the block with Mom and Dad. Perhaps he’ll discover that dried veggies can taste very similar to chips. Perhaps he’ll see that a 100 calorie pack of Oreos tastes like Oreos. The key to winning is reframing the problem. Bobby may understand better if Ref Kelli compares his body to a car. Cars need care and fuel to run, as do bodies. Mud in the gas tank will get a car just as far as all carbs will for a body. If this becomes a family game, he’ll be more interested. Blame has no role here. This is not necessarily anyone’s fault. But, now that it is an identified problem, the variables need to be examined and tweeked.

Ref Kelli has a few tricks up her sleeve she can pull out. Tie eating well during the week with a special treat on the weekends. Have Bobby help plan meals and even prepare them. Take him shopping and show him what portions are and calories. Kids are very visual. He may not understand he’s eating too much but he will get that 2 bowls of ice cream is putting mud in a car but 1 bowl with a piece of fruit is ok.

Kelli also has an option to throw up her white flag and call for backup. Her pediatrician is a phone call away and can help support this match to a more favorable outcome. One thing is clear, right now, the opponent is winning and Bobby is partially pinned.

The Grey Zone: All Bets Are Off

Bobby’s situation is obvious but many other kids fall into a vast grey zone where they may be normal or just a tad under or over weight.  For these kids, the key is not wrestling the match but training well so the match barely begins. Unlike Bobby whose match is clearly in progress, most other kids have a match lurking on the horizon that may never begin, especially if we train them correctly.

DG found herself in this situation very recently with her three kids, two girls and a boy, ages 4, 6 and 8, who appeared “normal” to her but whose karate instructor felt were underweight compared to other kids in the class. DG has always tried to focus on good health with her family.  “I try to serve healthy meals and my children enjoy a lot of healthy things that their peers won’t eat”, DG told me via email. “We consume low fat dairy and slim milk, eat and snack on a variety of cheese.  They all enjoy yogurt and even ice cream sometimes too. I serve fish twice a week, beans and beef weekly and we eat a lot of veggies, and chicken.”

Diet and exercise are clearly the prime determinants for overall health but bodies are all wired differently and have different needs. Think about that car engine again. While on paper they all may have the same RPM and horsepower, there will be slight differences from car to car. Bodies are the same way.

So, what works for one child may not work for another. A child’s growth parameter’s are what will clue us in to potential chinks in their health and fitness armor. A child who is proportional weight for height and with a normal BMI is the ideal. But that rarely happens. Often a child’s weight is a touch more or less than their height. This may not be an issue if the pattern over time is stable.  Changes in the pattern do need attention.

Kids who are having trouble gaining weight may need more calories while kids who are gaining too much weight need less calories and more activity. The latter is what happened with Bobby and is becoming all too common today.

Back to our story.

Reviewing the heights and weights DG sent me on standards growth charts was very interesting.  One of her daughters was actually a tad underweight for height while the other two kids had the opposite problem and were slightly overweight. This may all point to matches on the horizon more than an active issue depending on where these points fell compared to past growth. As the referee here, DG should be vigilant for sure but may not have to change much given the kids ages and activity levels.

I would suggest DG follow many of the same tips I suggested for Ref Kelli. If nothing else, empowering the kids to be more active and eat healthier can only benefit them in the long run. DGs goal is to change the game plan now so that these potential issues don’t become true battles.

What about the karate instructor’s observations? I’m not too surprised. Our litmus for “normal” is heavily altered today by the rise in childhood obesity. Relying on observation alone will be falsely reassuring for the many kids in the grey zone whose match bell is about to ring.

And The Winner Is…..

While beauty is in the eye of the beholder, we have to be honest about our kids’ weight status for their sakes. A child becoming overweight or underweight is simply telling you their body’s needs are different from what they are getting. So, change the game plan.

You’ll have some hurdles for sure. Studies today are clear that our kids are getting the wrong messages about foods from the media – this will thwart any attempts we make at teaching them to be healthy unless we become open and honest with our kids about the issues. Similarly, studies also confirm that all it takes is 15 minutes a day of vigorous activity for our kids to combat obesity. Even the busiest of families can fit that in!

Our kids’ bodies are already telling us what they need to be healthy.  All we have to do is listen carefully and referee their individual matches in whatever way makes them the winner.

(Originally posted May 2007; Updated December 2009)